Simulation-based training (SBT) has had a major positive impact on safety and operational costs in high-risk industries including aviation, aerospace and the military, and is now being applied to achieve similar benefits in healthcare. SBT is undergoing exponential growth in healthcare as the medical community recognizes its many demonstrated benefits: safe rehearsal of procedures without risk exposure to patients, the ability to provide standardized training and objective assessment, and the ultimate positive effect on patient safety, efficacy of care and reduction of risk exposure.
One example of a potential procedure that can benefit dramatically from SBT is peripheral nerve blockade. Interest in peripheral nerve blockade has increased dramatically in the past decade as it has been recognized that the procedure offers significant benefits in orthopedics and other applications. However, nerve blockade is also potentially harmful. Central nervous system and cardiovascular toxicity, including refractory cardiac arrest, are possible, albeit rare, complications of peripheral nerve blockade. Nerve injury, while usually temporary, is much more common, and studies have estimated its occurrence in 0.3% to 3% of peripheral blocks.
A variety of approaches have been pursued to simulate the multiple and varied aspects of peripheral nerve block procedures, including physical models, models with embedded conductive “nerves,” computer-simulated ultrasound, virtual reality (VR) systems with commercial haptic interfaces, and haptic devices to simulate needle force profiles during insertion. A fundamental design decision for simulation systems is the choice of physical or virtual models. Each type of simulation has merits and limitations for perceptual display and interaction.